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Hi-Touch Healthcare INTERPERSONAL & ORAL COMMUNICATION WHAT TO EXPECT IN THIS PRESENTATION Overview about the importance of communication Interpersonal communication principles • Activity: Word to the Wise Transactional Communication Model • Activity: Ping-Pong • Activity: Self-Reflection & Case Study Communication competency defined Impact of nonverbal communication and listening • Activity: “Fine” Perception process and perception-checking • Activity: On the Job Observation • Activity: Reflection, Analysis, and Role Play IMPORTANCE OF COMMUNICATION AND SOFT SKILLS “Communication is the skill that can possibly have the greatest impact on effective healthcare delivery. It really is the key to clinical governance and demands as much attention, respect and sustaining as other seemingly ‘harder’ targets. However, often the mere mention of the importance of communication causes less than positive reactions in healthcare professionals.” (Jelphs, 2006, senior fellow at the Health Services Management Centre at the University of Birmingham) MOST FREQUENTLY IDENTIFIED ROOT CAUSES OF SENTINEL EVENTS 2013-2015 Rank by Year Event Type 2013 # events 2014 # events 2015 # events Communication 2 563 3 489 3 744 Human Factor 1 635 1 547 1 999 Leadership 3 547 2 517 2 849 COMMUNICATION DEFINED Communication skills are made up of six closely related skills: – Listening – Verbal (oral) communication – Nonverbal – Written – Reading – Textual (using documents) https://alis.alberta.ca/pdf/cshop/workability.pdf Defined: “The act or process of using words, sounds, signs, or behaviors to express or exchange information or to express your ideas, thoughts, feelings, etc., to someone else” http://www.merriamwebster.com/dictionary/communication INTERPERSONAL COMMUNICATION PRINCIPLES 1) Communication is intentional or unintentional. 2) Communication is irreversible. 3) It is impossible not to communicate. 4) Interpersonal communication is unrepeatable. 5) Communication has both content and relational dimensions. (Adler and Proctor, 2011) ACTIVITY: WORD TO THE WISE PART ONE ACTIVITY: WORD TO THE WISE PART TWO ACTIVITY: WORD TO THE WISE PART THREE ACHIEVING COMPETENCY: APPROPRIATE AND EFFECTIVE (3 BASIC REQUIREMENTS) 1) Motivation 2) Knowledge 3) Skills I want to drive! Motivation I know the rules of the road-passed my written test! Knowledge I can apply knowledge to operate the automobile…safely! Skills ACTIVITY: TRANSACTIONAL COMMUNICATION: PING PONG Sender/Receiver Encode/Decode Sender/Receiver Message/Channel Feedback N O I S E CONTEXT Encode/Decode CONTEXT ACTIVITY: TRANSACTIONAL COMMUNICATION - USING THE MODEL Situation: A social worker is using blue tooth in her car to talk with her 80-year old client. The social worker is traveling on a rough road, in a noisy construction zone. After a few minutes on the call, both were yelling to be heard. The client got frustrated and hurt that her social worker was raising her voice. She hung up in a “snit,” exclaiming, “Call me when you can be polite!” ACTIVITY: WRITE & RESPOND CASE STUDY Discuss with your partner(s) a recent communication situation that did NOT result in a positive outcome. • Change the names of people for anonymity. Work as a team and write one brief case study (a description of a communication situation). • Write legibly. • These will be distributed to other teams for analysis. Evaluate the case study from another group and describe, using the transactional communication model, key terms and specific examples about how to improve the outcome. Share with the large group. THE MAJORITY OF OUR TIME COMMUNICATING IS SPEAKING AND LISTENING Speaking 30% Speaking 60% 30% 60% Listening 45% Listening 45% Reading 16% Reading 16% Writing 9% Types of Communication Activities Writing 9% Types of Communication Activities Based on the research of: Adler, Rosenfeld and Proctor (2001; 2011) NONVERBAL COMMUNICATION REALITIES You can never not communicate! Nonverbal communication: • • • • Helps manage our identity. Is ambiguous. Is relational and better at conveying emotions. Is contextual and cultural. BODY LANGUAGE: SOME SAY IT’S JUST ABOUT 65%...(BURGOON, 1994) Other’s have suggested the message impact % below when messages are related to feelings and attitudes: WORDS 7% What we do know for sure is that when words and body language don’t align, we believe the body language and paralanguage. Body Language 55% Tone of Voice 38% Based on the work by Albert Mehrabian ACTIVITY: “FINE” • First partner: Ask, “How are you?” • Second partner: Say the word “fine” and use a negative tone to suggest that you are not really fine. • Second partner: Ask, “How are you?” • First partner: Say the word “fine” and use a positive tone to suggest you are good. • First partner: Ask, “How are you?” • Second partner: Say the word “fine,” using an angry tone. • Second partner: Ask, “How are you?” • First partner: Say the word “fine” as if it’s your best day ever! ACTIVE LISTENING DEFINED The Centers for Disease Control (CDC) defines active listening as: • “hearing what is said and paying attention to how it is said so the conversation can be adjusted to elicit the needed response utilizing various verbal and nonverbal techniques”(CDC, n.d.). A FEW KEY ELEMENTS TO ACTIVE LISTENING THAT YOU PROBABLY ALREADY KNOW • Take it seriously! ― It takes effort and commitment • Provide effective feedback ― Body language and nonverbal communication • • • • • • • Talk less Listen to the words, tone, and feelings Listen with your eyes and ears Ask questions to clarify meaning Paraphrase to ensure you are understanding Suspend judgment and evaluate thoughts Be sincerely interested in the other person WHAT IS PERCEPTION? Simply put, each of us experiences a different reality. • This corresponds to what we have already learned: communication might be received (perceived) differently than intended. “We don’t see things as they are. We see things as we are.” Anais Nin THE PERCEPTION PROCESS 4 steps 1) Selection 2) Organization 3) Interpretation 4) Negotiation “Among the reasons perception is so important in interpersonal communication is that it influences your communication choices.” --Joseph Devito THINK ABOUT THIS: “One has not only an ability to perceive the world but an ability to alter one's perception of it; more simply, one can change things by the manner in which one looks at them.” TOM ROBBINS, Even Cowgirls Get The Blues ACTIVITY: PERCEPTIONS ON THE JOB • Partner up! • Situation one: A nurse, a custodian, and a volunteer are walking from the parking area to the front door and see a group of scrubwearing nursing students clustered near the smoking section. • What are the varied conclusions that can be drawn by the three observers? Why? SITUATION TWO: An administrator, a CNA, and a social worker are eating breakfast in the cafeteria and observe a surgeon complaining to an anesthesiologist. They overhear the surgeon exclaim: “What a needless waste of time having to attend communication training sessions when I could be saving lives!” • What are the varied perceptions of what they hear? SITUATION THREE: A patient, a family member, and a prospective new employee are walking down a hallway in YOUR organization. • What does each one see, hear, smell, feel, or notice? • When you leave this training today, make a point to notice your own perceptions. 3 STEPS TO PERCEPTION-CHECKING A perception check has three parts: A description of the behavior you noticed. At least two possible interpretations of the behavior. A request for clarification about how to interpret the behavior. ACTIVITY: PERCEPTION-CHECKING REFLECTION, ANALYSIS, & ROLE PLAY Steps • • • • Behavior Interpretation # 1 Interpretation # 2 Clarification Your turn • Think about a communication situation that led to misunderstanding or uncertainty • Write it out • Analyze it via the perception checking process • With your partner, role play for the large group EXAMPLE “You haven’t laughed much in the last couple of days.” • Behavior “It makes me wonder whether something’s bothering you” • First interpretation “or whether you’re just feeling quiet.” • Second interpretation “What’s up?” • Request for clarification “Communication, collaboration, and delegation are frequently thought to be 'soft skills'—despite that the majority of unintended medical errors involve a breakdown in communication among caregivers.” (Ray and Overman (2014) American Journal of Nursing) THANK YOU! Questions? Comments?